forms

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Intake Form

Thank you for preparing for your consult! I am looking forward to sharing ayurveda with you. Please download this intake form (PDF) and send it back to me prior to our appointment.

Download Intake Form

Please do not email this form to me, as email is not secure, nor reliable for medical information. You may scan or photograph the pages of the form after filling it out and zip up the files to upload below.

Upload files